The use of real-time, or continuous, X-ray is increasing rapidly because of the increased use of percutaneous medical procedures such as coronary stents, atrial ablation and gastric procedures. The doctors or other users in the operating room are forced to wear heavy lead aprons and sometimes goggles made of thick lead glass to avoid the cumulative effects of the X-ray radiation. A smaller dose of X-ray may reach persons far away from the X-ray machine. A common X-ray procedure is fluoroscopy, in which a portable arm carries an X-ray source at one end and a digital X-ray image sensor at the other end, with the patient placed between them. A screen connected to the image sensor via an image processing system displays real time images of the procedure. Some previous attempts to reduce the exposure of users to radiation used stationary lead shields, adjusted by the user. This is a time consuming operation. Other prior art solutions use electrically controlled masks that allow radiation to reach only part of the image. This is less than optimal, as without seeing the whole image it is difficult for the doctor to orient himself. The invention takes advantage of the fact that most of the image is changing very slowly and does not need as frequent updates as the area of interest. For example, when introducing a catheter into the body the area of interest is typically only around the catheter tip, but a much larger area needs to be seen for orientation. It is an object of the invention to reduce the X-ray exposure both for the patient and the doctor without degrading the image quality and information presented to the doctor. Another object of the invention is to improve image quality in the area of interest. A further object is to supply a system than can easily be incorporated into the design of existing fluoroscopy systems, or used as an add-on to existing systems. A further object is to introduce minimal changes in the use of the X-ray equipment compared to current practice, in order to avoid re-training. These and further objects will become clear by reading the disclosure in conjunction with the drawings.